门冬酰胺合成酶表达水平与儿童急性淋巴细胞白血病预后的相关性研究

Study of the correlation between the expression level of asparagine synthetase and the outcome of children with acute lymphocytic leukemia

目的探讨儿童急性淋巴细胞白血病（ALL）肿瘤细胞中门冬酰胺合成酶（As）基因表达水平是否与ALL的治疗反应和预后相关。方法用实时荧光定量PCR（Real—time Quantitative PCR，RQ—PCR）测定53例初发ALL患儿骨髓单个核细胞（BMMNC）ASmRNA水平，结合其临床资料，统计分析不同预后组患儿初诊时BMMNC中AS表达水平差异及其与预后的关系。结果未缓解组患儿AS表达水平最高，表达水平中位值为17．25（2．48—46．82），复发组其次，为14．28（3．20—54．47），持续完全缓解组患儿AS表达水平最低，为5．08（0．84—54．92），三组比较差异有统计学意义（P〈0．05）。合并未缓解和复发两组患儿，其中位ASmRNA水平为14．93（2．48—54．47），显著高于持续完全缓解组患儿（P〈0．01）。AS低表达组患儿白血病持续完全缓解率为84．6％，而AS高表达组患儿持续完全缓解率仅为53．8％（P〈0．05）。AS高表达组患儿的2年预计无病生存率为51．6％，显著低于AS低表达组患儿（84．6％）（P〈0．05）。结论AS高表达与患儿预后不良相关。

Objective To determine whether the high level of asparagines synthetase （AS） expression in childhood acute lymphocytic leukemia （ALL） is associated with an inferior prognosis. Methods AS mRNA level in leukemic cells from 53 newly diagnosed ALL children was measured by real time fluorescent quantitative PCR method. Patients were divided into groups according to their relapse risk and outcome, and the AS expression levels in each group were compared. The survival rates in different AS expressing level groups were estimated and compared. Results The highest level of AS [ median 17.25 （ 2.48 - 46.82） ] was observed in children failed remission, intermediate level [ 14.28 （ 3.20 - 54.47 ） ] in relapsed children and the lowest level [ 5.08 （0.84 - 54.92） ] in children with continuous complete remission （CCR） （ P 〈 0.05 ）. The AS mRNA level [ 14.93（2.48 -54.47） ] in children with poor outcome （ unremission and relapsed） was significantly higher than that in children in CCR（ P 〈 0.01 ）. The two-year estimated disease free survival was much lower in children with high AS expression （53.8%） than in those with low AS expression （84.6%） （ P 〈 0.05 ）. Conclusion High expression of AS is associated with a poor outcome in ALL children.